psc 126 exam 3

hypertension (definition)

Hypertension: High blood pressure -occurs when the supply of blood through the vessels is excessive

strategies for promoting resilience in the population

- want to teach resilliance before negative stressors occur -Focusing on the positive factors that reduce morbidity or delay mortality -Enhancing people's abilities to attract and maintain social support -Studying how people: =Spontaneously reduce stress =Seek out opportunities for rest, renewal, and relaxation

top 2 leading causes of death in us

-1) Heart Disease: 23.53% -2) Cancer (Malignant Neoplasms): 22.52%

dieting effectiveness and risks for future weight gain

-1. average weight loss through diet and/or exercise interventions is 5%-9% at 6 months followed by a plateau -2. lifestyle changes (exercise eating vegtables)are linked to better health outcomes even when very little weight is lossed -3.most patients who diet and lose weight regain most or all their weight within 5 years a. one to two thirds of participants regain more weight than they lost initially -dieting as risk factors for obeisity -4.yoyo dieting: successive cycles of dieting and weight gain a.enhances the efficiency of food use b. lowers metabolic rate (means that the body learns how to work with less calories so still eat large amounts of food so the body doesnt need the excess) -5.)set point theory of weight

flexible coping

-A flexible coping strategy that adjusts to the situation i.e., problem solving for controllable events (seeking out information for your disease), emotion-focused coping for uncontrollable events (try to put positive spin on it) -found in study that people with high coping flexibility had lower symptom severity than people with low coping flexibility -having high social support decreases severity even more in conjunction with flexibility

commonsense model of illness

-A set of beliefs held by people about their symptoms and illnesses -patients have their own theory of what the underlying illness is, shapes how these symptopms are then presented -the common sense model include basic info about the illness (people may have all these beliefs or just some) =identity- name of illness =causes- factors believed to have led to the illness =consequences- symptoms, tratments and their implications for quality of life =timeline-length of time illness is expected to last =control/ cure - wether the person belives the illness can be managed or cured =cohereance- how well these beleifs represent the disorder

anorexia vs bulimia

-Anorexia: Obsessive disorder amounting to self-starvation An individual diets and exercises to the point that body weight is grossly below optimum level, threatening health and potentially leading to death. -Bulimia: Alternating cycles of binge eating and purging through such techniques as vomiting, laxative abuse, extreme dieting or fasting, and drug or alcohol abuse Excessive concern with body and weight Preoccupation with dieting History of depression, psychopathology, and alcohol or drug abuse Difficulties with managing work and social settings

stages of delay in seeking treatment for sysmptoms

-Appraisal Delay: Time taken to decide that a symptom is serious -Illness Delay: Time between the recognition that a symptom implies an illness and the decision to seek treatment -Behavioral Delay: Time between deciding to seek treatment and then delay of calling doctor -Medical Delay: Time that elapses between the person's calling for an appointment and his or her receiving appropriate medical care

behavioral immunization (def and examples)

-Behavioral immunization= preventing the development of poor health behaviors and habits -if we could prevent people from negative health habits at a young age we could promote health -move from treating disease to preventing at 6 and 7th grade EX: Programs that focus on negative behaviors such as smoking, drug abuse; programs help with dieting and eating disorders -parents can contribute by = reducing the risks of accidents at home =practicing good stafety habitys =instilling good health habits in their children

lecture 14.) hypochondria

-Belief that normally bodily symptoms are indicators of illness, some people have a very low threshold for considering mild symptoms as severe

differences between men and women in the development of coronary heart disease

-CHD is the most common cause of death in women from developed nations -women develop heart disease later than men -estrogen prevents early onset of CHD reduces symathetic nervous system arousal (fight or flight increases cardiovascular reactivity) lowers incidence of high blood pressure and neuroendocrine and metabolic processes like cortisol -risk of CHD increases after menopause when estrogen decreases

stress and cancer

-Cancer flourishes when stress hormone levels are high (grows faster) -Norepinephrine and epinephrine implicated in metastatic process -Less clear that stress causes cancer onset (does not seem to be correlated with stress at onset but as cancer progresses stress then affects the growth) -Absence of close family ties in childhood predicts some cancers -Depression and absence of a current social support network worsens the course of illness -Women who are socially isolated are at greater risk of dying

risk factors for hypertension

-Childhood temperament and blood pressure reactivity -Gender- prior to age 45 men are more liklty to have hypertension than women, age 55-65 equal chances -Genetic factors- if both parents have hypertension there is a 95% chance for hypertension aswell -Emotional factors- depression is a risk factor -Family environment- a famly environment with lots of stress and anger = hypertension -Stress- job loss ect

comprehensive interventions model (def and examples)

-Comprehensive intervention models: interventions targeting multiple behaviors, problems, or risk factors (gold standard) -bring together all treatments/ interventions known for a probelm into a single cluster -can be costly but effective Examples Pain management programscombine physical therapy, cognitive behavioral therapy Hospice care Coordinated residential and outpatient rehab programs (address multiple health problems simultaneously) give treatments at home

obesogenic environment

-Defined as an environment that promotes gaining weight and that is not conducive to weight loss -that the social environment we live in encourages us to eat and overeat -Portion sizes for most dishes in the US have doubled or tripled in the past 20 years

causes of delay in seeking tratment for symptoms

-Delay is common among people: some people dont have regular contact with a physician some peoole are phobic about medical services -Symptoms that delay seeking treatment: symptoms similar to a previous one that turned out to be minor symptoms that do not hurt or change quickly not seen as big issue symptoms that are easily accommodated, easier to ignore (ie not being able to walk is important) -typical symptoms of a disorder are more likely to be treated than atypical sysptoms (atypical sysmtoms lead to delay because people dont know what do do with them) -delay in taking recommended tratments patients no longer feel any urgency about their condition (now that they know what it is) patients become alarmed by the symptoms and avoid thinking about them delay by health care practitioner medical delay is likely when a patient deviates from the profile of the average person with a given disease (if somebody is presenting with a group of sysmptoms that the practioner hasnt seen before this leads to delay because they are told to try things for a while that are not applicable)

preventative measures for obeisity

-Diet or diet + exercise (what is reccomended) -Surgery -Cognitive behavioral therapy (CBT) Screening- taking tests Self-monitoring- monitoring what you are eating Stimulus control- teaching people to get rid of unhealthy snacks around the house Controlling eating Self reinforcement Controlling self-talk- teaching people to not talk down on themselves Adding exercise Stress management- teach how to cope with stress Social support Relapse prevention -Training parents on sensible meal-planning and eating habits -Changing lifestyles at a young age -School-based interventions -Social engineering strategies

managemant of the heart disease (psychosocial aspects)

-Dietary instructions and exercise program- -Stress management -Treating depression- -Social support -Addressing invalidism (patients and their spouses see the patient's abilities as lower than they actually are) (people dont want to hurt their heart so they dont do anything) thus to prevent this it needs to be agressed that people do need to be active to help heart

immune system (main fuction)

-Distinguishes between what is self and what is foreign -Attacks and rids the body of foreign invaders

how individual therapy in chronic illness differs from regular therapy

-Episodic, collaboration with physician & family, comprehensive understanding of illness and modes of treatment, respect for patient's defenses

positive emotional changes in response to chronic illness

-Experiencing positive reactions and optimism: the feeling that they have excaped death in some way, -Inspiration to act now instead of postponing it: may say, "life is short so I have to give myself the best chance to succeed and act now" -Acquiring more empathy and compassion: when people go through such a tough period in their life they may feel more empathy towards others -Feeling stronger and more self-assured: people say "ive made it this far and ive gone through so much to get here i must be so strong"

psychosocial factors that increse or decrease HIV progression

-Factors that increase disease progression -Negative beliefs about the self and the future -Depression -Stress -Trauma -Psychological inhibition -Factors that decrease disease progression -Optimism -Active coping -Extraversion -Conscientiousness -Spirituality

strategies for improving patient (provider communication)

-For Providers Listen Use clear, jargon-free explanations. Repeat instructions Write down instructions Single out and clarify unclear recommendations Use simple, warm and supportive behaviors Watch nonverbal communication -For Patients Come prepared with brief but detailed descriptions of symptoms Think of questions ahead of time Listen well. Ask clarifying questions

anorexia; causes

-Genetic factors Genes involving the serotonin, dopamine, and estrogen systems, (ie the same ad anxiety disorders) connections with annorexia and other disorders such as OCD which causes then to become focused on the anorexia -Interactions between genetic and environmental factors (family teasing them about their weight) Dysregulated biological stress systems (HPA axis) (alterations in HPA axis in eating disorders) Personality characteristics (perfectionism) Family interaction patterns (family making fun of person)

childhood causes of obeisity

-Genetics -Forceful feeding style- ecouraging kids to eat everything on their plate -Sedentary lifestyle -Depends on the number and size of an individual's fat cells

ghrelin

-Ghrelin: stimulates appetite -Discovered in 1999 Secreted by specialized cells in the stomach Spikes before meals and can be increased by dieting (when dieting feel more hungry then they were before) Sleep deprivation and stress can increase ghrelin levels

health disparities (def, examples, causes)

-Health inequalities: Inequalities in patterns of distribution of morbidity and mortality (diseases and mortality affect different groups in different rates) -Causes: low ses indicator for... =Alcohol consumption and tobacco use =High levels of lipids and obesity =Fewer psychosocial resources =Higher rates of chronic illness =Low birthweight =Infant mortality =Higher risk of accident -Examples: =Racial and ethnic differences =SES and ethnic differences- have an impact in the delivery of medical treatment (women werent even included in studies for many years) =Gender- women are not includes as research subjects in studies of many major diseases

risk factors for coronary heart disese

-High LDL cholesterol → Can contribute to plaque buildup -High blood pressure → Can injure the blood vessels, this leads to cellular debree floating around that lead to inflamation and narrowing of the atrteries Elevated levels of inflammation → Contributes to plaque and its rupture; the immune system produces an inflammatory response to the plaque, creating hart disease Diabetes → High blood sugar which can damage blood vessels Cigarette smoking → Increases blood pressure, chemicals from tobacco can damage blood vessels Obesity → Linked to high blood pressure Lack of exercise → Exercise can improve blood pressure and regulate blood sugar

leptin

-Hormones that signal to the brain whether the body has enough energy -Leptin: inhibits appetite signals that you are full -Discovered in 1994 Secreted by fat cells In obesity, leptin levels are high but in some people the brain becomes insensitive to leptin if levels are high for long periods of time so peole are not signaled that they are full

HIV infection (what is it, which immune cells are under most attack, how it progresses)

-Human immunodeficiency virus (HIV): A virus that attacks the T helper cells and macrophages of the immune system -Targets T helper cells and macrophages -Rapid growth in the first few weeks -After 3 to 6 weeks viral growth is gradual, compromises the immune system by killing T helper cells, creates vulnerability in immune system to opportunistic infections -aids is the finals step of HIV infection (aquired immune deficiency syndrome) -

lecture 12.) chronic disease defition and examples

-Illnesses that are long lasting (3 or more months) and usually irreversible. -Generally cannot be prevented by vaccines or cured by medication -they are typically ongoing and in need of general management over life -50% of Americans suffer from a chronic disease at any point in time -Management of these conditions takes up about 75% of health care costs -Can range from moderate (e.g., partial hearing loss) to life-threatening (e.g., cancer) -Examples of chronic diseases: Heart disease, diabetes, arthritis, cancer, asthma, chronic fatigue, fibromyalgia , hearing loss

lecture 17.) health trends in US

-Life expectancy has been increasing but differ due to SES's -Fewer traffic related deaths -Prevalence of smoking has been slowly decreaseing -Fewer adults exhibit high cholesterol levels -Exercise habits are improving -Rates of coronary heart disease have been decreasing, eventhough it is still the number 1 cause of death in the us -However, Negative trends: =Rates of obesity are rising =No change in alcohol consumption =No change in prevalence of many mental health problems, some have increased

cyberchondria

-Looking up stuff on the internet for information from illness (obsessive), 59% of adults use it

examples of immune cells and what they do (focus only on macrophages, neutrophils, NK cells, Bcells and helper T cells)

-Macrophages First responders, primarily kill invaders, produce inflamatory response -Neutrophils Also kill invaders -NK cells Attack tumor cells and virus-infected cells -B cells Produce antibodies, which are proteins specific to each invader that bind to the invader and help killer cells identify and neutralize the invaders -T helper cells Help activate other immune cells

attentional differences (in role in symptom perception)

-People who are focused on themselves are quicker to notice symptoms -People with more distractions and who attend less to themselves experience fewer symptoms (dont notice)

psychological interventions in chronic illness (examples)

-Pharmacological interventions Example: prescription of antidepressants for people who have developed depression as a result of their chronic illness - individual therapy- (differences between psychotherapy with medical patients and psychotherapy with patients who have primarliy psychologival disorders) -when depression is related to a medical diagnisis treatment is more episodic than continuous, chronic issues tend to have issues that pop up every now and again so often times therapy is to treat when is going on with those rather than consistent therapy -its really important that the therapist is in collaboration with patient's physician and family so the family can best help the patient - therapy Requires some respect for patients defenses. so often times in therapy the goal is to challeng the patients defences, however with chronically ill patients t might better serve them to let them keep some of their defences up because it prevents them from seeing the full ramifications of their illness -reguires that the therapist has a comprehensive understanding of the illness and its modes of treatment. So a therapist may give incorrect assumptions of the illness if they dint fully understand, could be frustrating to the patient to have to describe everything - individual therapy is often Guided by cognitive behavioral therapy (CBT) to target specific problems. maybe they have a chronic illness but they also have alot of stress in their life so they are then tryimg to target the stress - another common intervention is teaching Coping skills training can improve functioning for chronic diseases by increasing knowledge of the disease for the patient and reduce anxiety about it through coping mechanisms; Increases patients' feelings of purpose and meaning in life -Relaxation, stress management, and exercise Relaxation training and acceptance and commitment therapy (ACT) are widely used; teaches to accept the problem and be aware of its occurance and changed behaviors Mindfulness-based stress reduction (MBSR) Improves adjustment to medical illness; teching individuals to have a higher awareness of the presence and accept the present Exercise can improve the quality of life -Social support interventions Family support: expecially important can enhance patients functioning Enhances patient's physical/emotional functioning Promotes adherence to treatment Improves course of illness -Support groups: discuss issues of mutual concern that arise as a consequence of illness; teaching familiy members how to help their sick family menber Low-cost, convenient treatment option

rhematoid arthritus vs osteoarthritus (definitions)

-Rheumatoid -Autoimmune process that attacks the own body -Affects the small joints of the hands, feet, wrists, knees, ankles, and neck -immune system attecks the thin membranes around the joints -causes inflamation and stiffness -3x more common in women -Osteoarthritis Articular cartilage begins to crack or wear away because of overuse, injury, or other causes -affects weight bearing joints -causes depression pain and distress -this is not an autoimmune disease like rhematoid, osteo is due to overuse

metabolic syndrome (symptoms and what the syndrom is a risk factor for)

-Risk factor for CHD -Associated with 2-3-fold increased risk of cardiovascular events/death and 5-fold increased risk of developing type 2 diabetes -Diagnosed when a person has 3 or more of the following (doctors discovered that many sysmptoms are associated with coronary heart disease): Obesity centered around the waist High blood pressure Low levels of HDL ("good cholesterol") Difficulty metabolizing blood sugar High levels of triglycerides -thought to be a dysfunction of metabolism that clusters itself in these ways; not just one, 3 or more

coping strategies commonly used by cancer patients (cognitive vs behavior escape)

-Social support/direct problem-solving: might say "i talked to someone to find out more about the problem" they are using their social supports to go to get direct answers and not avoiding problems -Distancing- say "I dont let it get to me" there is something that is there but it is away from them -Positive focus- "say i came out of this experince better than i went in" -Cognitive escape/avoidance- say "I just wish this experinve would just go away" cognitively ignoring it -Behavioral escape/avoidance- doing something like eating sleeping, doing any sort of activity to take your mind off of the problem, ex. somebody who just got diagnsed with cancer may get super into exercise to take their mind off it

psychological risk factors for poor immune functioning

-Stress -Depression Decrease in cellular immunity Prolonged innate inflammatory responses---> systemic inflammation (more peoplewho are depressed show this pattern) Sleep disturbance has a negative effect on immune system -Insecure attachment---> lower NK(kill tumor cells) cell cytotoxicity, this is bad because there are then less cells to fight off tumors -Chronic interpersonal stress predicts inflammatory activity -Marital conflict and partner violence -Caregiving for someone ill -loneliness -all related to greater levels of inflamation and lower levels of cellular immunity

systolic vs diastolic blood preassure

-Systolic pressure= pressure in the arteries during contraction of the heart muscle (ideally less than 120) the high number -Diastolic pressure= pressure in the arteries when teh heart is relaxed (ideally less than 80) (diastolic sounds like dialating which means it is relaxed) -high blood pressure 140/90

quality of life measures (def and componenets)

-The extent to which a patient's normal life activities have been compromised by disease and treatment. -Components: Physical functioning: are you mobile, can you do things for yourself Psychological status: the presence or absence of things like depression or anxiety Social functioning: the extent yiu are engaging socially, do you have social support Disease- or treatment-related symptoms: measures the syptoms that your disease causes you, (ex shortness of breath due to your asthma)

how myocardial infarction happens

-The plaque with too much LDL builds up and narrows arteries -Plaques send messages that alert the immune system -White blood cells try to help heal the site and become trapped in the plaque -Inflamed plaque grows and the plaque ruptures, then blood clot forms -Ruptured plaques are the cause of 70% of heart attacks -Blood flow is interrupted, heart attack or cardiac deaths ensue -C-reactive protein (CRP) predicts heart attacks and strokes -Statin drugs reduce both cholesterol and inflammation

lecture 15.) psychoneuroimmunology (definition)

-The study of the interactions between psychological experiences, the activity of the brain and that of the immune system -there are interactions between the immune system and the brian and the implactions those have on our health -the nervous system is making changes based on the immune system and then behavior chmages -ie when yiu are sick your behavior can change or if you have bad behavior like you are stressed this can effect the immune system

prevalent of overweight and obeisity in us

-United States has the highest rate of overweight and obesity in the world -68% overweight (BMI > 25) -34% obese (BMI > 30) -this is happening because the portion sizes

challenges in managing type 1 diabetes (expecially in adolecents)

-active involvement of the patient in the treatment process is essential to success: regular insulin injections, dietary control, weight control and exercise -Adherence is very low (only 15% of patients!!!) and especially difficult in adolescents they like to be independent, so must be taught coping skills -Glucose levels should be monitored, kept steady, and action should be taken if required -psychologists can help teach coping skills and self regulation needed to improve adherance

adjusting to cancer (interventions)

-coping with physical limitations =pain and discomfort =fatigue and compromised nutrition =body image issues -stress-reduction intervetions (ex. mindfullness) muscle relaxation -promoting social support (family support or support groups) -finding meaning helps -writng interventions result in fewer symptoms -individual or family therapy these help people cope better with cancer

lecture 13.) coronary heart disease (causes)

-coronary heart disease a type of cardiovascular disease which is a disease of the heart or blood vessels -linked to lifestyle factors -illness caused by atherosclerosis, which is defined as the narrowing of coronary arteries -a waxy substance called plaque builds up inside coronary arteries (made up of LDL cholesterola and other substances) -coronary ateries are the arteries that supply the heart with blood, if there is a blockage in these then the heart is deprived of oxygen rich blood can eventually lead to heart attack or stroke -plaque narrows the coronary ateries and reduces the flow of oxygen rich blood to the heart

problems in the health care system (focus on 3: cost, inequity, innapropriate use)

-cost: very expencive -inequity: inequitable system: not everyone has acess to it -innappropriate use of services: about half - 2/3 who seek medical care have complains related to psychological factors so they are not using vists appropariatly

type 2 diabetes (definition, sysptoms, and risk factors)

-definition: Diabetes: A metabolic disorder in which the body becomes incapable of manufacturing or properly using insulin. Insulin is needed to keep blood glucose levels in the normal range -symptoms- co occur with irregular blood sugar (similar to those of type 1) -1) Frequent urination 2) Fatigue and dryness of the mouth 3) Impotence 4) Irregular menstruation 5) Loss of sensation 6) Frequent infection of the skin, gums, or urinary system 7) Pain or cramps in legs, feet, or fingers 8) Slow healing of cuts and bruises 9) Intense itching and drowsiness -risk factors Overweight Little exercise High blood pressure Sibling or parent with diabetes Had a baby weighing over 9 pounds at birth (because having a large baby causes isuuses with blood sugar) Being a member of a high-risk ethnic group which includes African-Americans, Latinos, Native Americans, Asian Americans, and Pacific Islanders2

stroke (definition, causes, warning signs and risk factors)

-definition: Results from a disturbance in blood flow to the brain -causes: Blood flow to localized areas of the brain is interrupted; Cerebral hemorrhage -warning signs Sudden numbness or weakness of the face, arm, or leg, especially on one side of the body. Sudden confusion, trouble speaking, or understanding Sudden trouble seeing in one or both eyes Sudden trouble walking, dizziness, loss of balance or coordination Sudden severe headache with no known cause -risk factors (same as heart attack) High blood pressure Heart disease Cigarette smoking High red blood cell count Transient ischemic attacks- brief strokelike attacks that forcast future stroke Negative emotions Sudden change in posture to a startling event Psychological distress

emotional responses to to chronic illness (denial, depression, anxiety)

-denial: Defense mechanism by which people avoid the implications of an illness; Interferes with absorption of treatment information and compromises health (not going to take into account the information to then get better) denial can be helpful in the begining ot not feel everything all at once, but can later interfere with treatment -Depression: (can sometimes be delayed because it takes a while to undersatnd the implicatoins of the illness) Assessing it in the chronically ill can be complicated. People who get depressed: (people who) Experience pain and disability get depression, Experience negative life events, Lack social support. (not sure if the symptoms are from the actual disease or from the depression) -Anxiety: Patients become overwhelmed by potential changes in their lives and/or the prospect of death Interferes with treatment (anxious patients cope more poorly with surgery and can then exasperate the symptoms)

causes of problems in patient and provider communication

-depersonalization: medical providers see body disconnected to the person -stereotypes of patients: doctors can have assumptions about different types of people -innatentaiveness: we dont always pay attention

weight stigma

-having negative attitude towards obese persons -discrimination Begins early in life (age 3) -Most people assume that weight stigma is justifiable because weight is within one's control Despite scientific evidence that environmental causes, genetics, and prenatal nutrition are major determinants of weight Despite scientific evidence that most weight-reduction interventions are ineffective or have modest success (ie if somebody wanted to loose weight we dont have an effective way to do so) -Most people also assume that weight stigma is a useful tool to motivate people to lose weight It is not: increases in weight stigma are linked to increases in binge eating and decreases in exercise behavior Randomized trials which promote weight acceptance and self-esteem promote weight loss -Also most people dont get to choose the environment in which they live in

medical risks associated with obeisity

-higher Death rates for all cancers when obsese Especially cancers of the digestive tract e.g., colon, rectum, esophagus, but also multiple myeloma. -Cardiovascular disease, atherosclerosis (hardening of arteries), hypertension, Type II diabetes, and heart failure. Abdominal fat is an especially potent risk factor; this fat tissue produces pro-inflammatory cytokines and inflammation plays an important role in cardiovascular diseases and diabetes. measure midsection -Increases risks in surgery, anesthesia administration, and childbearing Avoiding health care services due to weight stigma Major cause of disability Difficulty performing basic tasks (driving, dressing oneself) Lowers the drive to exercise Poor cognitive functioning Associated with early mortality (minus 3 years of lifespan on average) Can cause psychological, social, and economic stress (unfair treatment)

protective factors (ie beneficial factors) for immune functioning

-protective effects of psychosocial resources (improve link between psycholog and immune function) -Social support can buffer against adverse immune change in response to stress -resources like finances limit deteroration in immune functioning -Optimism -Personal control/ benefit finding -People considering stressor as uncontrollable show adverse immune effects compared to people who believe that they have control over their stressors -Factors responsible for beneficial effects on immune =Prioritizing goals =Emphasizing relationships, personal growth, and meaning in life

Role of stress in coronary heart disease

-psychological stress plays a role in the development of CHD -cumulative effects of biological reactivity to stress lead to damage of the edothelial cells; when you have a fight or flight response blood pressure goes up ect. which can cause damage if chronic -sympathetic nervous system activity during fight or flight response accelerates heartbeat, increases blood pressure (those who dont have good coping skills, take a long time to recover after stressor, can have the same effect) -prolonged recovery period ( poor parasympathetic function) after stress can also cause damage -chronic and acute stress are both linked to CHD and adverse clinical events, acute being like being held at gunpoint can trigger a heart attack -stress interacts with genetic factors to increase liklihood of CHD, important to know family history of coronary heart disease -stress is also associated with increased inflammatory activity

effect of chronic illness on self concept, self esteem, and body image (also se textbook)

-self concept: a set of beliefs about ones own personal qualities; changes in this due to illness can be permanent or temporary; Evaluated by self-esteem- (wether one feels good or bad about these personal qualities from self concept) -there are some aspects to self concept: -Body image: the perception and evaluation of ones physical functioning and appearance; Poor body image raises the risk of depression and anxiety. Influences a person's adherence to treatment, so if treatment is making you not feel great about how you look, you will be less likely to do it -Achievement - job related, people derive alot of their life satisfation through jobs or hobbies and if they feel they cant do these things their self concept may be damaged; Important to self-esteem and self-concept -social self: social resources provide info to patients for help and emotional support; fears of being abandoned by social supports are a common worry for chronically ill -private self: patients ambitions, goals and desires for the future and this can be altered through crinic illness and damage your identity (ie cant move need to be near their specialist)

comparison of healthcare systems (criteria used for comparisons)

-some people value different criteria aspects differntly -Costs: Cost per capita, Administrative cost, Value for cost (the ratio) -Health Outcomes: Life expectancy and infant mortality; Morbidity, mortality, prevalence of various diseases -Quality of Care: Effective care, Safe care, Coordinated care (how many people does a person have to interact with to get treatment), Timely care, Patient satisfaction, Patient choice -Social Justice Issues: Health inequities/disparities, Access -Medical Performance: Advancement of research and technological breakthroughs, High-quality services available for those with good insurance, Availability of new technology to patients

stress (role in symptom perception)

-stress: stress related physiological changes are interpreted as symptoms of illness (the physiological effects of stress) - some people may decide that these normal symptoms of stress are symptopms of illness

innate/natural vs aquired/specific immunesystem

-the 2 branches of the immune system/ stress has different effects on these 2 branches -Innate/natural immunity -Generalized defense against all types of pathogens Macrophages- large cells that eat other cells neutrophils- similar role to macrophages NK cells- attack tumor cells and virus-infected cells -Acquired/specific immunity -specific immune response to a specific pathogen ie aquired through flu vaccine or contacting a disease (chicken pox) -Delayed response to a specific invader -Specific to each pathogen Humoral immunity---> B cells (mature in bone marrow), they produce and secrete antibodies Cellular immunity---> T cells (mature in thalamus), operate at a cellular level Ex: T helper cells

lay refferal network

A network of family and friends (and internet) who offer their own interpretations of symptoms before the treatment is sought

cancer (definition and risk factors)

A set of more than 100 diseases with different causes and courses Common feature: they result from a dysfunction in DNA (dysfunction in the immune system) Cancer: Uncontrolled growth of cells Interventions help reduce risk factors and improve coping Risk factors -Family history (genetics) -Race/ethnicity -Culture and lifestyle (example: smoking) -Socioeconomic Status- exposed to environmental --carcinogens -Marital Status -Diet

bulimia; causes

Different stress responses Higher cortisol levels Large body mass- (people who are overweight tend to use this more) Depression and substance abuse Genetics and hormonal dysfunctions Family values- (unhealthy disccusions about weight) Low leptin functioning-(signals when we are full, people can be genetically predicposiioned to have low leptin levels) Hypothalamic dysfunction- (hypothalamus is central to eating and body weight) Food allergies- (people who have some other digestive issues are more prone to this) Disordered taste responsivity Disorder of the endogenous opioid system- (pain response system linked to bulimia) Neurological disorder- (more prone to bulimia)

lecture 11.) obeisity definition

Excessive accumulation of body fat of BMI over 30 (but BMI may not be accurate, but is easy to use)

set point theory of weight

Each individual has an ideal biological weight, which cannot be greatly modified can be modified by 5-9% but not much more

C-reactive protien

Protein made by the liver when inflammation is high; indicator of inflamation or nonresolving inflamation in the body, indicates chronic stress

carcinogen (def)

Substance or exposure that causes cancer

results from NHANES study

Survey of 18,098 adults in the U.S. using 2003-2010 data (An et al., 2016) Participants responded to questions about their diet in the past two days Compared eating home-prepared meals with full-service restaurants and fast food restaurants -it is just as bad to eat at a restaurant or fast food meal, when you eat out they put more bad things on it then what you would put on it -In general, restaurants generate the most calories/cholesterol/sodium per day, fast-food in the middle, and home-prepared meals the least.

type 1 diabetes (definition, causes, age of onset)

Type 1 diabetes = autoimmune disorder characterized by the abrupt onset of symptoms resulting from lack of insulin production by the beta cells of the pancreas. It is a chronic condition Causes: immune system attacks bodys own tussue (pancreus) Can appear following viral infection or stress Likely has a genetic contribution Arises early in life → ages 5-6 or 10-13